Generally, when paying health care benefits for employees, an employer may be faced with the annual task of negotiating new purchasing prices from potentially hundreds of different health care and dental care providers and associated products. The process for conducting such annual negotiating primarily involves each interested health care provider submitting price quote and coverage information to the employer for subsequent analysis and compilation.
Submission of price quote, coverage, and health care service history information has typically been performed using paper forms which further require employer personnel to manually copy the data into a resident computer system for the subsequent review, compilation and evaluation. In addition, each health care provider typically submits their respective information in a format of their own choosing.
Because the creation and processing of these forms is very labor intensive for both the providers and the employer, existing negotiating processes are highly inefficient and time consuming, particularly since the volumes of forms and information contained therein must be reviewed for errors, non sequiturs, insufficient and/or incomplete information. If any of these deficiencies are identified, the employer must seek clarification from the particular provider to supplement the previously received information. The fact that information must be manually copied from the submitted forms further increases the likelihood of human error or failure to fill out the forms with all necessary information.
In addition, centralized and automated administrative processing of such submitted forms is also difficult and labor intensive, particularly given the diversity of the various types of health care coverage and policy terms. Further, because the overall process is very time consuming, providers are required to submit all information well in advance of the actual rate renewal period. As a result, information regarding price quotes and other inherently transient factors conveyed by providers tends to be prospective, particularly with respect to price quotes which are estimated on the high side, and therefore introduces uncertainty and potential inaccuracy in employer quality assessments if rate information subsequently changes.
Therefore, a need exists for an improved method and system for collecting and processing health care provider information to increase efficiency and accuracy of managed care rate renewal in an abbreviated or timely manner.